Black, Jason L.

Black, Jason L. is an sole proprietor health care provider with primary practice located at 3109 Bienville Blvd Department Of Emergency Medicine, Ocean Springs MS 39564-4361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Black, Jason L. can be contacted via phone (228) 818-1111.

Contact Information

Primary practice address
3109 Bienville Blvd Department Of Emergency Medicine Ocean Springs MS 39564-4361
Phone: (228) 818-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X T-2070 Mississippi

Profile Details

NPI number 1508029083
LBN Legal business name Black, Jason L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2008
Last updated Jun 20th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508029083 NPPES
Mississippi Other 20838 PERMANENT LICENSE NUMBER

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